I stumbled across this article while evaluating a persistent CPK elevation in an applicant with HLD and other CHD risk factors.
Pharma
Risks and Benefits of ARBs and ACEis
There are three links in this article to the original comparative effectiveness review, a clinician guide, and a consumer guide.
Good training stuff for your newbies.
Scary Chart of the Day – 08.19.10
Pretty ugly looking trend
From 1999 to 2007, the number of U.S. poisoning deaths involving any opioid analgesic (e.g., oxycodone, methadone, or hydrocodone) more than tripled, from 4,041 to 14,459, or 36% of the 40,059 total poisoning deaths in 2007. In 1999, opioid analgesics were involved in 20% of the 19,741 poisoning deaths. During 1999–2007, the number of poisoning deaths involving specified drugs other than opioid analgesics increased from 9,262 to 12,790, and the number involving nonspecified drugs increased from 3,608 to 8,947.
Arava (leflunomide) – Watch Those Liver Enzymes
The FDA has expanded the black box warning to the label of the rheumatoid arthritis drug leflunomide (Arava) to include possible fatal liver damage.
The agency received 49 adverse event reports — including instances of jaundice, coagulopathy, encephalopathy, and 14 fatalities — about the drug from August 2002 to May 2009. Of the patients reporting adverse events, 36 were hospitalized.
Metformin May Lower Mortality in T2DM Patients
Medical News: ADA: Mortality Lower with Metformin – in Meeting Coverage, ADA from MedPage Today
A large, multicenter trial found a 24% reduced risk of all-cause mortality among patients on the drug, compared with those not taking it, according to Ronan Roussel, MD, PhD, of Groupe Hospitalier Bichat-Claude Bernard in Paris, and colleagues.
Right or Wrong? Part Deux
Right or Wrong?
BBC News – Insulin giant pulls medicine from Greece over price cut
Before you formulate an opinion, make sure to read the last sentence in this article.
By way of compensation, he said the company would make available an insulin product called glucagen, free of charge.
New ASA Advice
A more conservative approach to aspirin for primary prevention in adults with diabetes is called for in a joint statement issued today by diabetes and cardiovascular associations.
Low-dose aspirin can be considered reasonable for diabetes patients with a cardiovascular disease risk above 10% over 10 years and no excess bleeding risk, according to the statement released by the American Heart Association, the American Diabetes Association, and American College of Cardiology.
Anticonvulsant Meds and Suicide Risk
Results: The study identified 26 completed suicides, 801 attempted suicides, and 41 violent deaths in 297 620 new episodes of treatment with an anticonvulsant (overall median follow-up, 60 days). The incidence of the composite outcomes of completed suicides, attempted suicides, and violent deaths for anticonvulsants used in at least 100 treatment episodes ranged from 6.2 per 1000 person-years for primidone to 34.3 per 1000 person-years for oxcarbazepine. The risk of suicidal acts was increased for gabapentin (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.11-1.80), lamotrigine (HR, 1.84; 95% CI, 1.43-2.37), oxcarbazepine (HR, 2.07; 95% CI, 1.52-2.80), tiagabine (HR, 2.41; 95% CI, 1.65-3.52), and valproate (HR, 1.65; 95% CI, 1.25-2.19), compared with topiramate. The analyses including violent death produced similar results. Gabapentin users had increased risk in subgroups of younger and older patients, patients with mood disorders, and patients with epilepsy or seizure when compared with carbamazepine.
Conclusion: This exploratory analysis suggests that the use of gabapentin, lamotrigine, oxcarbazepine, and tiagabine, compared with the use of topiramate, may be associated with an increased risk of suicidal acts or violent deaths.
Combination Therapy for Crohn’s
Better Treatment Found for Crohn’s Disease – BusinessWeek
The international trial included 508 people with Crohn’s disease who had never been treated with immunosuppressive drugs. One-third were given infliximab alone, one-third received only azathioprine and one-third were treated with both. The trial was funded by Centocor Ortho Biotech, which markets infliximab, and Schering-Plough.
After 26 weeks, 56.8 percent of those getting combination therapy had complete remission of symptoms, compared to 44.4 percent of those getting only infliximab and 30 percent of those getting only azathioprine.
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